Combined Liver-Kidney Transplantation in a Patient with Acute Liver Failure Coexisting with Acute Renal Failure
Abhasnee Sobhonslidsuk MD*, Bunyong Phakdeekitcharoen MD*, Surasak Leelaudomlipi MD**, Piyanuch Pootrakul MD**, Somchai Viengteeravat MD***, Pattana Sornmayura MD****, Suthat Sriphojanart MD**
Affiliation : * Department of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Surgery, Ramathibodi Hospital, Mahidol University *** Department of Anesthesiology, Ramathibodi Hospital, Mahidol University **** Department of Pathology, Ramathibodi Hospital, Mahidol University
Acute renal failure (ARF) is common among patients with liver failure awaiting liver transplantation due to the increased waiting time for available liver grafts and extended survival from improved intensive care. The role of combined liver and kidney transplantation (LKT) in this situation is quite controversial. A case of acute liver failure (ALF) complicated with ARF is reported. Non-A, non-B hepatitis was the cause of ALF. He had hemodialysis for one month before transplantation. Combined LKT was performed because of prolonged pre-transplant hemodialysis and the potential of irreversible renal failure. Severe impairment of both native kidneys was confirmed by renal scan at 6 months after transplantation. Combined LKT may be needed for patients with acute liver failure complicated with prolonged acute renal failure.
Keywords : Acute renal failure, Acute liver failure, Cirrhosis, Liver transplantation, Kidney transplantation
